A single-center cohort study on the clinical characteristics and risk factors of ischemic stroke associated with cardiac myxoma

Qiao Manli; Ma Liping; Li Kunyu; Wu Yangjiao; Tu Zunmei; Shu Zhenzhen; Shui Chuntao

doi:10.3760/j.issn.1673-4777.2024.04.005

Abstract：Objective To investigate the clinical characteristics and risk factors of ischemic stroke associated with cardiac myxoma,and to provide evidence for early identification and diagnosis of ischemic stroke associated with cardiac myxoma.Methods A total of 408 patients with cardiac myxoma admitted to Beijing Anzhen Hospital,Capital Medical University from January 2010 to December 2020 were retrospectively collected.The clinical manifestations of patients with cardiac myxoma and ischemic stroke associated with cardiac myxoma were analyzed,and the risk factors of ischemic stroke associated with cardiac myxoma were analyzed.Results Among 408 patients with cardiac myxoma,396 patients were included in the analysis,including 48 patients with ischemic stroke associated with cardiac myxoma and 348 patients with cardiac myxoma without ischemic stroke.The clinical symptoms of cardiac myxoma were atypical,mainly characterized by cardiac obstruction,embolism,and constitutional symptoms.In the acute phase of ischemic stroke associated with cardiac myxoma,nerve function defect in patients was mild-to-moderate,with the national institutes of health stroke scale score of 3(interquartile range:1-10)and the majority of patients(56.3％,27/48)in the nervous system symptoms as the first and the only.Multivariate Logistic regression analysis showed that tumor width＜30 mm,tumors with high-mobility,thrombus on the tumor surface,and lower B-type natriuretic peptide levels were independent risk factors for ischemic stroke associated with cardiac myxoma(all P＜0.05).Conclusions The clinical manifestations of cardiac myxoma are diverse.Patients with ischemic stroke associated with cardiac myxoma are characterized by mild to moderate neurological deficits in the acute phase.Tumor width＜30 mm,tumors with high-mobility,thrombus on the tumor surface,and lower B-type natriuretic peptide levels are potential risk factors of ischemic stroke associated with cardiac myxoma.